Nonprofit Human-Service Organizations, Social Rights, and Advocacy in a Neoliberal Welfare

State
Author(s): Yeheskel Hasenfeld and Eve E. Garrow
Reviewed work(s):
Source: Social Service Review, Vol. 86, No. 2 (June 2012), pp. 295-322
Published by: The University of Chicago Press
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Nonprofit Human-Service
Organizations, Social Rights,
and Advocacy in a Neoliberal
Welfare State

Yeheskel Hasenfeld
University of California, Los Angeles

Eve E. Garrow
University of Michigan

The hallmark of the welfare state is the extension of social rights to the most vulnerable,
a cause historically championed by nonprofit human-service organizations. With the rise
of neoliberalism, these rights are threatened. This article attempts to show how the in-
stitutional, economic, and political environment of the nonprofit human-service sector is
reshaped by a neoliberal ideology that celebrates market fundamentalism. The ideology
institutionalizes such rules and practices as new public management, devolution, and
privatization of services. Those elements shift the political discourse about the rights of
the most vulnerable from the national to the local level. By turning vulnerable citizens
into consumers, the ideology also reduces the national visibility of their needs. Most
importantly, neoliberalism dampens the sector’s motivation to challenge the state and
greatly curtails its historical mission to advocate and mobilize for social rights.

The vast literature on the role of nonprofit human services in the Amer-
ican welfare state focuses mostly on the sector’s relations with govern-
ment, especially on relations that stem from the provision of publicly
mandated services (e.g., Salamon 1995; Grønbjerg and Salamon 2002;
Boris and Steuerle 2006). Less attention is given to a fundamental ques-
tion about the role of the sector in advancing social rights, which lie at
the core of the welfare state. As Elisabeth Clemens and Doug Guthrie
(2010, 2) note, there is a lacuna in the study of the sector’s role in
electoral politics and policy formation. This article explores the non-

Social Service Review ( June 2012).

䉷 2012 by The University of Chicago. All rights reserved.
0037-7961/2012/8602-0004$10.00
296 Social Service Review

profit sector’s political role in advancing social rights and focuses par-
ticularly on the sector’s ability to do so within the current neoliberal
regime.1 It shows that important sector actors successfully advocated for
social rights in previous eras but that advocates encounter formidable
barriers within the current political context. It also shows that the
sector’s capacity for advancing social rights is diminished at a time when
social citizenship is increasingly threatened.

Nonprofit Human-Service Organizations and Social Rights

By advocating for social rights, nonprofit human-service organizations
have played a key role in the formation and expansion of the American
welfare state. Social rights, as defined by T. H. Marshall (1964, 72), are
“the whole range from the right to a modicum of economic welfare and
security to the right to share to the full in the social heritage and to live
the life of a civilized being according to the standards prevailing in the
society.” The essential principles are that each citizen is entitled to an
acceptable standard of living, that this standard is protected from market
forces, and that it is guaranteed as a matter of right, not through some
assessment of deservingness. As Margaret Somers (2008, 70) so aptly notes,
the very idea of citizenship “is the right to have rights—the foundational
public good for every person to be a member of a preexisting civil society
and political community.” Of course, social citizenship is an ideal whose
actual implementation in the American welfare state has been conten-
tious, fragile, and suffused with racial and gender biases (see, e.g., Quad-
agno 1990; Neubeck and Cazenave 2001). Its implementation also is
driven to distinguish between the “deserving” and “undeserving” (Han-
dler and Hasenfeld 1991, 37). Nonetheless, the idea that social citizen-
ship is the moral justification for the welfare state is the underlying
political theme employed by welfare state advocates in pushing govern-
ment to accept responsibility for the care of its citizens (Handler 2004).
Nonprofit human-service organizations pursued and affirmed social
rights during the Progressive Era, advocated for the passage of Social
Security during the Great Depression, and mobilized for political action
during the civil and women’s rights movements of the 1960s. To be sure,
there have always been organizations that reject the advancement of
social rights (Clemens 2010). Some in the sector viewed such rights as
a threat to their autonomy and as a usurpation of their service mission.
Examples include the Charity Organization Societies and the Red Cross.
Nonetheless, the political context in these eras tended to favor the
advocates.

1. In the current study, the contemporary term “nonprofit human-service organizations”

is used to include what has been referred to in the literature as voluntary social service
associations and charitable organizations. The term “civil society associations” here denotes
all voluntary associations that exist in the public space between government and market.
 Advocacy for Rights 297

Since the late 1970s, however, a neoliberal ideology has risen to dom-
inance, altering the institutional, economic, and political landscape for
nonprofit organizations. This cultural shift affects the regulation, finance,
and provision of social services by public, nonprofit, and for-profit actors.
It has led to a new politics of care played out through devolution and
privatization of services. This study’s key argument is that, amid such
institutional transformations, social rights are doubly threatened: they are
threatened by increasing dependence on the market behavior of non-
profit and for-profit human-service organizations; they also are threatened
by declines in advocacy and mobilization by nonprofit human-service
organizations, which have shifted away from social rights.

Nonprofit Human-Service Organizations and the Rise of

Social Rights
Since the early days of the republic, nonprofit human-service organi-
zations have played a pivotal role in creating organizational responses
to human needs (McCarthy 2003). They foster private-public relations
in funding and managing these services. They also promote social ad-
vocacy for the rights of women, children, and the poor (McCarthy 2003).
Many were at the forefront in the struggles to abolish slavery, to oppose
President Andrew Jackson’s Indian removal bill (4 Stat. 411 [1830]), to
outlaw prostitution, and to protest poor working conditions for women
(McCarthy 2003, 98–191). To be sure, these organizations also expressed
prevailing racial and religious prejudices. Some charities, such as the
New York Children’s Aid Society, were openly contemptuous of the poor
(McCarthy 2003, 174).
At the turn of the twentieth century, a dense landscape of nonprofit
human-service organizations dotted cities. They ran orphanages, hos-
pitals, reformatories, and mental hospitals. They offered assistance to
the poor and responded to emerging social needs. These organizations
developed innovative social services that became models for policy mak-
ers to emulate (Mohr and Guerra-Pearson 2010). Many of these agencies
operated in close collaboration with local public welfare departments,
becoming important partners to local government in the provision of
social services.
Nonprofit human-service organizations and voluntary social service
associations were particularly visible and instrumental in influencing
social policy during three pivotal periods: the Progressive Era, the Great
Depression, and the 1960s. In the Progressive Era, coalitions of women’s
associations organized into federations with local branches. They acted
as powerful advocates for a broad array of social policies to protect
mothers and children. From their advocacy came minimum wages for
working mothers and the mothers’ pension (Skocpol 1992). Various
298 Social Service Review

social reformers coalesced into a “child saving” movement that scored

important achievements in public education, juvenile justice, and public
health (Katz 1986, 130).
A distinctive feature of many of these associations is that they com-
bined legislative advocacy with services to their constituents. The Young
Women’s Christian Association, the General Federation of Women’s
Clubs, and the settlement house movement provide poignant examples.
Located mostly in poor urban areas populated by recent immigrants,
the settlement house movement flourished during the Progressive Era,
providing such basic services as education, health clinics, day care, and
safe playgrounds for children (Fabricant and Fisher 2002, 29). Settle-
ment workers argued that the causes of poverty are structural; that
services to the poor must be based on collaborative relations between
community residents and the workers; that residents should work to-
gether to improve social conditions, thereby learning and exercising
their citizenship rights; and that social action is the key to combating
economic, political, and social inequalities (Fabricant and Fisher 2002).
At the local level, settlement workers fought for urban reform as well
as for improvements to public education and facilities; at the state level,
“they battled for statewide tenement house reform, child labor laws,
. . . and women’s suffrage” (Katz 1986, 161). Jane Addams, Florence
Kelly, and other leaders of the settlement house movement were at the
forefront in establishing juvenile courts, supporting mothers’ pension
legislation, and founding the federal Children’s Bureau (Skocpol 1992,
350).
Although settlement houses and other Progressive Era associations
advocated for social rights, it is important to note that their advocacy
was partial and contingent. For example, the settlement houses re-
mained mostly inaccessible to racial minorities. They assumed a pater-
nalistic orientation toward the immigrants they served and sometimes
imposed middle-class culture and values on the working class (Carson
1990, 197). During the 1920s, the movement became increasingly pro-
fessionalized and imbued with a social casework approach. It also faced
an increasingly inhospitable political climate. Because of these devel-
opments, “many settlements toned down their advocacy of reform”
(Carson 1990, 180).
Not all Progressive Era charitable organizations supported social
rights, and some dominant nonprofit human-service organizations
voiced opposition. The Charity Organization Societies opposed the
mothers’ pension partly because it threatened their charitable hege-
mony and clashed with their notions of “scientific philanthropy” (Lu-
bove 1968, 40; Leff 1973, 339). Similarly, agencies providing institutional
care for children in New York tended to oppose the mothers’ pension
for fear that it would empty their institutions (Fitzgerald 2006, 175–80).
A vigorous mobilization to demand social rights took place during
 Advocacy for Rights 299

the Great Depression. It was propelled, in part, by the massive lines of

ordinary people at the relief offices. The breadth of need shattered the
typical stereotypes of the pauper and the undeserving poor (Piven and
Cloward 1977). Public and private social welfare agencies were ill
equipped to provide relief at such a scale. Many private agencies were
not capable of responding and simply dissolved (Katz 1986, 213–14).
To bear witness to the scope of unemployment and to influence federal
legislation, the settlement houses and other agencies began to gather
data. Through their professional associations, social workers argued that
the federal government bears responsibility for public assistance. They
monitored and critiqued the implementation of the federal relief pro-
grams, protesting when Franklin Roosevelt’s administration planned to
quit the relief business.
Throughout the country, the unemployed mobilized themselves in
councils, protesting their condition (often violently). Joined by the mass
mobilization and organization of the industrial workers, they pushed
for expansion of federal relief efforts and for unemployment insurance
(Piven and Cloward 1977). The Congress of Unemployment and Social
Insurance is one of several coalitions formed by trade unions, church
groups, women’s associations, civic associations, and newly organized
“rank-and-file” social workers to advocate on behalf of the unemployed
(Fisher 1980, 91). The powerful pension movement (e.g., the American
Association for Old Age Security and the Townsend movement), which
rose during the Depression, was a major force in pushing Congress to
pass the Old Age Assistance program and the Social Security Act of 1935
(49 Stat. 620; Amenta, Caren, and Olasky 2005). Equally important was
a network of women advocates. This “second generation of Progressive
reformers” was instrumental in convincing legislators to include the Aid
to Dependent Children program in the final Social Security legislation
(Katz 1986, 222). They also played an important role in child labor
prohibitions enacted as part of the Fair Labor Standards Act (52 Stat.
1060 [1938]; Katz 1986, 222).
Support for Aid to Dependent Children was not universal. Catholic
Charities objected, for example, to the Federal Emergency Relief Ad-
ministration’s proposal to extend the definition of a “fatherless” child
(Brown and McKeown 1997, 173). The expanded definition would iden-
tify children as fatherless if they were under the age of 16 and lived in a
household where there was no adult “able to work” (i.e., unemployed;
Brown and McKeown 1997, 173). Catholic child-caring institutions feared
that many children would be moved to families in which they would be
supported by the Aid to Dependent Children program.
Clemens (2010, 105–9) shows that the Roosevelt administration’s com-
mitment to extend social rights was tempered by its reluctance to un-
dermine private charity. A compromise was worked out between the
federal government and nonprofit human services. The nonprofit sector
300 Social Service Review

cast itself in a new role, innovating and experimenting with programs

that might then influence social policy.
Often forgotten is the eloquent endorsement of social rights in Frank-
lin D. Roosevelt’s State of the Union Address on January 11, 1944.
Engaged in the war effort and facing the implications of the return of
soldiers at the war’s end, Roosevelt proposed a second bill of rights:
We have come to a clear realization of the fact that true individual freedom
cannot exist without economic security and independence. . . . We have accepted,
so to speak, a second Bill of Rights under which a new basis of security and
prosperity can be established for all—regardless of station, race, or creed. Among
these are: The right to a useful and remunerative job in the industries or shops
or farms or mines of the nation; The right to earn enough to provide adequate
food and clothing and recreation; The right of every farmer to raise and sell
his products at a return which will give him and his family a decent living; The
right of every businessman, large and small, to trade in an atmosphere of free-
dom from unfair competition and domination by monopolies at home or abroad;
The right of every family to a decent home; The right to adequate medical care
and the opportunity to achieve and enjoy good health; The right to adequate
protection from the economic fears of old age, sickness, accident, and unem-
ployment; The right to a good education. (Roosevelt 1944, 41)

Although never enacted into law, Roosevelt’s second bill of rights laid
the groundwork for subsequent struggles for political and social rights
in the civil rights and the women’s rights movements of the 1960s (Sun-
stein 2004). Ensuing movements led to considerable expansion of the
welfare state. Medicare, Medicaid, Supplemental Security Income, and
the Food Stamp Program all stem from these movements. Often for-
gotten is the important role played by the Community Action Centers,
most of which were incorporated as private nonprofit organizations.
They combined the delivery of social services with political mobilization
of low-income residents. As Noel Cazenave recounts (2007), the federal
government sponsored the Community Action Program (CAP) to mo-
bilize residents in poor neighborhoods who were disfranchised from
local political institutions and the public and private social welfare ser-
vices in their communities. The program was most effective in mobilizing
African Americans. Indeed, Kenneth Andrews (2001) shows how civil
rights movements in Mississippi counties were influential in securing
increases in funding for CAPs, such as the Child Development Group
of Mississippi. Despite the political backlash and the program’s ultimate
takeover by local political establishments, CAP succeeded in launching
the movement for community control of schools. Through that move-
ment, parents in poor neighborhoods organized to demand improve-
ments in the education for their children and reforms in urban gov-
ernment. Those changes allow residents in poor neighborhoods to
participate actively in local school policy making (Cazenave 2007, 174–
75). The movement also planted the seeds for the National Welfare
 Advocacy for Rights 301

Rights Organization, which pushed for the expansion of public aid and
encouraged welfare recipients to exert their rights (Cazenave 2007, 177–
78).

The Rise of Neoliberalism

The American welfare state in the 1950s and 1960s is characterized by
what David Harvey (2005, 11) terms “embedded liberalism.” By this he
means that “market processes and entrepreneurial and corporate activities
were surrounded by a web of social and political constraints and a reg-
ulatory environment that sometimes restrained but in other instances led
the way in economic and industrial strategy” (Harvey 2005, 11). Monica
Prasad (2006) notes that US taxation, industrial, and welfare state policies
pursued a fairly egalitarian strategy in this period. Between 1947 and
1968, family income inequality, as measured by the Gini coefficient, de-
creased by 7.5 percent ( Jones and Weinberg 2000), and the highest mar-
ginal tax rate ranged from 70 percent to 92 percent. The nonprofit hu-
man-service sector operated in a policy environment that at least partially
encouraged social equality and the expansion of social rights.
Much of that environment changed with the rise of neoliberalism. Its
rise is epitomized by the administrations of President Ronald Reagan.
According to Harvey (2005, 2), “Neoliberalism is in the first instance a
theory of political economic practices that proposes that human well-
being can best be advanced by liberating individual entrepreneurial
freedoms and skills within an institutional framework characterized by
strong private property rights, free markets, and free trade.” Its moral
underpinnings are individual liberty, competition, individual responsi-
bility, and work ethic. As such, “the responsibility of the individual vis-
á-vis society is to be able to find means of self-sustenance and not to be
‘assisted’ by society. . . . Social protection should not be redistributive
and should be individualized in the sense that aid should be granted
in exchange for something [work]” (Amable 2011, 22–23). In particular,
neoliberalism recasts the role of the welfare state by shifting responsi-
bility from state to market and from the collective to the individual
(Taylor-Gooby 2004).
Neoliberalism also reflects the institutional logic of business manage-
ment: new public management (NPM). In its idealized form, NPM em-
braces several themes, including reorganizing public organizations into
product and cost centers, shifting toward competition within and among
public organizations and the private sector, adopting corporate man-
agement strategies, seeking alternative and cost-efficient modes of ser-
vice delivery, adopting “hands-on management,” employing measurable
standards of performance, and using explicit output measures (Hood
1995, 98). Steven Hays and Richard Kearney (1997) venture beyond
this to identify principles of NPM: reducing the size of government,
302 Social Service Review

adopting business models in government, devolving program adminis-

tration to state and local governments, restructuring government to
emphasize results over processes, and privatizing services.
Identifying the reasons for the rise of neoliberalism is beyond the
scope of this study.2 Rather, the authors wish to highlight how neolib-
eralism rejects the ideal of social rights, alters the environment in which
nonprofit human services operate, and has negative consequences for
their ability to advocate for social rights. According to Prasad (2006,
45), three major policies signify the institutionalization of neoliberalism.
The first of these is the Economic Recovery Tax Act of 1981 (95 Stat.
172), which effected “the largest tax cut in American history” (Prasad
2006, 45). The second is the deregulation of business and especially the
financial institutions. The third is the Omnibus Budget Reconciliation
Act of 1981 (95 Stat. 357), which curtailed eligibility for Aid to Families
with Dependent Children (AFDC) program benefits, prohibited AFDC
recipients from seeking reimbursement for work-related expenses, and
gave the states the ability to experiment with various welfare-to-work
options. The act laid the groundwork for the ultimate passage of welfare
reform in 1996 (see also 110 Stat. 2105). As Jacob Hacker and Paul
Pierson (2010) note, the resulting policy environment contributed to
an unprecedented rise in income inequality and to a concentration of
wealth in the highest income strata. Nathan Kelly and Peter Enns (2010)
show that public opinion increasingly supports a conservative ideology
that is hostile to the expansion of social rights. This ideology further
reinforces income inequality.
As a result of the institutionalization of neoliberalism, nonprofit
human-service organizations must respond and adapt to changing gov-
ernment policies that emphasize contracting out, devolution, and pri-
vatization (Grønbjerg and Salamon 2002; DeVita and Twombly 2006;
Smith 2006). Under a contract regime, they are subject to the logic
of NPM, which forces them to shift from a value-driven calculus to
one driven by efficiency (Frumkin and Andre-Clark 2000).

The New Economics of Care: Contracts, Vouchers,

and Competition
The neoliberal policy environment, particularly devolution and priva-
tization as they are exemplified in the Temporary Assistance for Needy
Families (TANF) program, altered the economics of the care provided

2. Often mentioned are the stagflation and the decline in corporate profits in the
1970s. These developments led to the mobilization of business interest groups as well as
to increases in the political power of the Republican Party and its alliance with the Christian
right. They also led to the continuing decline of labor unions, the rise in prominence of
neoliberal think tanks, and the proliferation of media generously funded by corporations
(see, e.g., Harvey 2005; Hacker and Pierson 2010).
 Advocacy for Rights 303

by nonprofit human-service organizations. This environment increases

their already quite extensive dependence on government funding but
subjects them to greater competition (Salamon 2003; Boris et al. 2010).
Steven Smith (2010) notes that contracts for human services grew as a
result of the shift toward block grants in the 1980s. He also ties this
growth to state and local governments, which increasingly relied on
Medicaid (and later TANF) as a source of funding for social services.
Reductions in federal social-welfare spending (e.g., on social, employ-
ment, and training services, as well as on community development) also
fueled the nonprofit sector’s dependence on these funding sources be-
tween 1980 and 2004. Alan Abramson, Lester Salamon, and C. Eugene
Steuerle (2006, 113) show that, “measured as share of GDP, in fact,
federal spending in this area as of FY 2004 was only 57 percent as great
as it was in FY 1980.” State and local governments compensate for federal
cuts by using Medicaid funds to finance child welfare, mental health,
home health, and counseling; most of these services are delivered by
private providers (Smith 2006).
The increasing use of contracts by state and local governments at-
tracted many new organizations, both nonprofit and for-profit, to the
field of human-service delivery. Peter Frumkin (2002) calculates that
the number of nonprofit social service providers increased by 125 per-
cent from 1977 to 1997, but the number of for-profit providers increased
by 202 percent. In the same period, revenues increased 704 percent for
nonprofits and 827 percent for for-profits. In family services, job train-
ing, child care, and residential care for the elderly, competition comes
from other nonprofits as well as from for-profit organizations.
In addition, providers have been forced to adapt to a changing land-
scape of new funding allocation rules and patterns. This landscape fea-
tures “government promoted policy tools designed to reduce costs, fos-
ter choice among clients, and develop competitive social service and
contracting environments” (DeVita and Twombly 2006, 263). It is char-
acterized by increasing reliance on consumer vouchers and fees for
service (i.e., consumer-side subsidies) rather than direct grants and con-
tracts (i.e., producer-side subsidies); the use of tax credits to promote
new services (e.g., low-cost housing); reliance on managed care and
third-party intermediaries; and increasing enforcement of performance-
based contracts (Smith 2010). The cumulative effects of these policy
instruments changed the organizational field and its rules of the game
for nonprofit human services. The changes are manifest in the entry of
for-profit organizations, growth in competition, and increases in ex-
posure to market forces (Grønbjerg 2001). In addition to increasing
the sector’s dependence on various forms of government funding, these
developments further blur the distinction between nonprofit and for-
profit organizations (Frumkin and Andre-Clark 1999). The field is also
experiencing considerable uncertainty as state and local governments
304 Social Service Review

grapple with declining resources and the federal government attempts

to slow growth in Medicaid expenditures (Smith 2006). Moreover, the
field is becoming dominated by large organizations that are able to
attract the greater share of government resources; medium- and small-
sized organizations are losing ground (DeVita and Twombly 2006, 265–
66; Boris et al. 2010).

The New Politics of Care: Devolution and Privatization

Devolution and privatization have also altered the politics of care. They
represent an ideology that claims that the state and its bureaucracies
would be more responsive to its citizens if entitled services were devolved
to the local level and subjected to market principles. This ideology
pursues those goals through competition among public agencies, entry
of nonprofit and for-profit providers, and private sector entrepreneur-
ship in the public sector (Suleiman 2003, 15).

Devolution
Devolution is justified as a way to strengthen local democracy by bringing
government closer to its citizens. It is supposed to enable local author-
ities to tailor services to the particular needs of the local population. It
also is intended to increase citizens’ access to and control over local
governments’ bureaucracy. Although devolution confers considerable
discretion to local authorities, these authorities often use it to embed
their own moral values, ideologies, and interests in the structure and
practices of the social services they control. Those positions may be at
odds with the desires or needs of service recipients (Hasenfeld 2000;
Brodkin 2007). For example, availability of and access to contraceptives
and abortion vary markedly across so-called blue and red states. This
variation reflects differing dominant ideologies about family values.
Those local ideologies become embedded in local policies and services
(Cahn and Carbone 2010), influencing the capability and willingness
of local authorities to invest resources into local programs that provide
care. The extent to which local services are responsive to the needs of
local citizens, especially those who are poor and vulnerable, is influenced
by the local political elite, local government bureaucracies and practices,
and the efforts of various interest groups that see devolution as an
opportunity or as a threat. Moreover, funding formulas, such as the
number of welfare recipients removed from the rolls or placed in jobs,
create powerful financial pressures. This also is true of the federal and
state monitoring criteria associated with contracts. These incentives and
constraints influence the local implementation of the program. In par-
ticular, local authorities have an incentive to limit benefits, reduce costs,
 Advocacy for Rights 305

and shift some of the burden to the consumers (Fording, Soss, and
Schram 2007).
John Donahue (1999) argues that devolution is associated with in-
creases in economic inequality, and he ties this inequality to differential
policy making at the local level. As local communities compete with
each other to attract desirable constituents (e.g., business entrepre-
neurs) and repel undesirable constituents (e.g., poor immigrants), they
will attempt to gain advantages by using policy-making discretion in
such areas as taxation, labor, education, and antipoverty services. To the
extent that devolution accentuates inequality, it reduces social solidarity
and impedes political consensus. Devolution also hampers the capacity
of civil society to create and sustain bridging associations rather than
bonding associations (Putnam 2000).

Privatization
The logic of privatization is that “the state, like the private sector, pro-
vides services. It is, in this sense, a producer. The citizen pays for those
services when he or she purchases a service from a provider. . . . The
purchaser is entitled to the best deal, and it can only be obtained in
nonmonopolistic, competitive conditions” (Suleiman 2003, 51). The
logic of privatization claims that the introduction of market mechanisms,
especially competition, will motivate private contractors to deliver ser-
vices of higher quality than that possible from government sources and
to deliver them as efficiently as possible. The results, proponents claim,
are better services for clients and cost savings for government (Donahue
1989; Sclar 2000).
Despite shifting the responsibility for social care from the government
to private providers, privatization rarely achieves the claims that pro-
ponents use to justify it. In particular, it does not improve the quality
of care (Donahue 1989; Sclar 2000; Van Slyke 2003; Lamothe and La-
mothe 2010). There is some evidence to suggest that competition may
be negatively associated with quality of service (Schlesinger, Dorwart,
and Pulice 1986; Milward and Provan 2000; Fernandez 2007). Indeed,
because quality of care cannot be readily observed or measured, effi-
ciency criteria enforced in a contract regime are likely to displace quality.
There is also little evidence to suggest that privatization achieves cost
savings (Van Slyke 2003).
A possible reason why privatization achieves no cost savings or quality
improvement may be the ability of social care contractors to exploit the
contracting environment. Measures of outcome are exceedingly difficult
to define, and the government is highly dependent on information
controlled by the service providers. Because clients are generally de-
pendent and marginalized, they have limited capacity, if any, to judge
and communicate their assessments of quality to government officials.
306 Social Service Review

Moreover, government agencies in charge of accountability have limited

capacity to enforce it (Van Slyke 2003). The complexity of the contract-
ing environment requires more staff resources and expertise than down-
sized public agencies possess.
Indeed, as Brinton Milward and Keith Provan (2000, 359) point out,
privatization creates a “hollow state” in which there is a fundamental
shift from the perspective that citizens are principals and officials are
agents to the view that officials are principals and private providers are
agents. This shift is accompanied by a change in the way that public
services are delivered: offerings formerly delivered by a public bureau-
cracy are now distributed through a network of private providers. In
the “hollow state,” government officials “are continually faced with prob-
lems that can lead to instability—negotiating, coordinating, monitoring,
holding third-parties accountable, and writing and enforcing con-
tracts—all for organizations that are relatively independent of the
funder” (Milward and Provan 2000, 363).

The Erosion of Social Citizenship?

What happens to the concept of citizenship, and particularly to that of
social citizenship, when public services are devolved and privatized?
Under devolution, which grants broad discretion to local authorities,
the exercise of social rights, especially by the poor and the marginalized,
becomes contingent on local political and bureaucratic practices. Rather
than being an expression of universality, social rights become contingent
on the exercise of local discretion. Local social services turn into arenas
where competing interest groups fight over and negotiate contested
moral assumptions about the poor. In particular, political elites use the
administration of local services to advance their political aims. Because
the poor are powerless, their voices are unlikely to be heard. Thus, the
increased politicization of social care subjects the well-being of the poor
to the vagaries of the local political landscape. For example, Richard
Fording and colleagues (2007) study the use of TANF sanctions by coun-
ties in Florida, finding that rates of sanction are higher in more polit-
ically conservative counties and in those with a higher poverty rate.
Under privatization, citizens become customers. This shift has several
consequences for social rights. First, the reconstruction of the citizen
as a customer shifts the onus for securing needed services from the state
to the individual, obscuring the reciprocal responsibility of citizen and
state; that reciprocal relationship is the basis of social rights. Citizenship
creates a community of interest that is essential to sustain democracy.
As Ezra Suleiman (2003, 52) argues, “To be a customer requires no
commitments and a responsibility only to oneself. To be a citizen re-
quires a commitment and responsibility that goes beyond the self.” Som-
ers (2008, 69) differentiates between contract and citizenship, stating
 Advocacy for Rights 307

that “contracts are the life-blood of markets—quid pro quo instruments

of voluntary commercial exchange between equivalent goods, services
or monies. Citizenship, in contrast, is the life-blood of social solidarity
in civil society and political communities comprised of non-contractual
membership rights, relationships, and reciprocal responsibilities.”
Neoliberalism, with its logic of market fundamentalism, transforms
“the rights and obligations of citizenship from an ethic (if not always
the reality) of non-contractual reciprocities based on the rights and
responsibilities of equal inclusion, into one in which the right of social
inclusion is conditional on being party to a market exchange of equiv-
alent value” (Somers 2008, 72). Thus, citizen empowerment is framed
in terms of choice within the market economy, and failure to obtain
needed services is no longer the fault of the state but rather the failure
of the individual to transact effectively in the market. Especially in the
case of consumer vouchers, citizens are expected to express their dis-
satisfaction through exit rather than voice (Hirschman 1970). Those
with personal resources are more likely to exit than to remain, leaving
behind the highly marginalized, who are least likely to voice their pro-
test. Consequently, vulnerable citizens are not only unlikely to see im-
provement in the quality of services but may even witness further de-
terioration. As Somers (2008, 89) puts it, “People who have nothing to
offer or exchange in the way of useful labor or personal assets—the
poor, the very young, the infirm, the severely disabled—have no rights
because they have no worth; they become rightless and excluded.”
Second, privatization creates an infrastructure of private organizations
that mediate the citizen’s relationship with the state. As a result, social
rights become dependent on the market behavior of private service
providers. Citizens find it difficult to exercise their rights because these
are channeled through nonprofit and for-profit organizations that act
as agents of government; social rights are contingent on citizens’ de-
sirability as consumers. Their needs and services are subject to a calculus
of efficiency and profitability. In their study of case managers employed
by private providers of welfare-to-work services, Sanford Schram and
colleagues (2010, 747) find that “market pressures imposed on imple-
menting organizations rain down on the case manager from above, and
it is the case manager who, in turn, must work to secure market com-
pliance from the client.” Workers in these organizations use their dis-
cretion to determine eligibility for entitled services and to discriminate
between desirable and undesirable clients (Alexander 1999). Desirable
clients add to the profitability of the organization; processing and treat-
ing them requires fewer resources, and they score well on the outcome
measures set by government (Forder 1997).
Third, under privatization, citizens’ awareness of the relationship be-
tween the benefits they receive and the state’s obligation to provide
them is obscured by their more direct interactions with the intervening
308 Social Service Review

private sector. Because they are so distanced from public officials, they
have limited awareness of who is responsible for services. If dissatisfied
with services, they are likely to misidentify the nonprofit provider as a
government agency (Van Slyke and Roch 2004) and, thus, are not likely
to comprehend the chain of accountability that runs from the state via
the nonprofits to them.

The Paradox of Advocacy and Mobilization

When social rights are threatened, the role of civil society associations
to advocate for them, especially at the national level, becomes partic-
ularly critical. Paradoxically, all indications suggest that these associa-
tions meet current threats with a muted response. Despite the rapid
increase in the number of nonprofit organizations and civic associations
since the 1980s, the new economics and politics of care have in fact
compromised the capacity and effectiveness of civil associations and
nonprofit organizations to advocate and mobilize for the social rights
of marginalized populations. At the same time, a new rhetoric promotes
bottom-up policy making and the empowerment of citizenry.
As noted earlier, a robust growth in the nonprofit human-services
sector in recent decades outpaced the growth of the overall economy.
From 1995 to 2012, the number of registered nonprofit human-service
organizations increased by 33 percent and their total revenues (in con-
stant dollars) increased by 73 percent (Urban Institute 2012); the US
gross domestic product increased by 46 percent from 1995 to 2011
(Bureau of Economic Analysis 2012).3
Despite the sector’s growth in size and resources, most of these or-
ganizations’ policy advocacy efforts are marginal, limited, and narrowly
focused. In a recent national study of advocacy by nonprofit organiza-
tions, Gary Bass and associates (2007) find that 75 percent of organi-
zations claim to have engaged in political activity at least once but that
the frequency of such activity is extremely low. As Bass and associates
(2007, 29) note, “Seventy percent [of the respondents] said they either
never lobby or do so infrequently. In fact, three out of five nonprofits
that say they [lobby] do so at a low level.” In a survey of nonprofit
organizations in Indiana, Curtis Child and Kirsten Grønbjerg (2007)
find that about 23 percent of all organizations engage in some kind of
advocacy and most devote limited (if any) resources to it. Only 7 percent
of the organizations devote substantial resources to what the authors
define as “core advocacy” (Child and Grønbjerg 2007, 268). A majority
of human-service organizations indicate that they are unlikely to engage
in any advocacy and rarely engage in core advocacy. Interestingly, the

3. It is possible that part of the growth may be due to increasing registration by or-
ganizations normally exempt from filing (e.g., religious organizations).
 Advocacy for Rights 309

study finds that substantial reliance on government funding reduces the

odds of engaging in core advocacy.
In a study of lobbying efforts by citizen groups, Jeffrey Berry (1999)
finds that the agendas of these groups have shifted since the 1960s; once
motivated by material concerns and issues of economic equality, the
groups now focus on culture, environment, morality, lifestyle issues, and
individual rights issues. Frank Baumgartner and colleagues (2009) reach
a similar conclusion. In their study of a random sample of policy issues
in two periods (1999–2000 and 2001–2), they find that liberal groups
gave little attention to the issue of poverty and the plight of low-income
families. Such groups were more interested in environmental issues than
efforts to “expand benefits to the unemployed, raise the minimum wage,
improve social or educational services in disadvantaged neighborhoods,
or promote other issues where one could easily argue that substantial
social needs exist” (Baumgartner 2009, 256). Thus, organized lobbying
efforts on behalf of social rights were very limited. Theda Skocpol (2003,
240–44) also concludes that advocacy and support for inclusive social
provision declined substantially. She identifies economic equality issues
that constituted 13.5 percent of the legislative agenda in 1963: increases
in wages, benefits, or pensions; expansion of job training; improvement
of working conditions; provision of income maintenance; and provision
of basic health coverage. Skocpol then notes that the share of the leg-
islative agenda devoted to these issues was 9.5 percent lower in 1991.
Why do advocacy efforts to extend social rights at the national level
decline even as the nonprofit sector grows? Skocpol (2003) argues that
the rights revolution of the 1960s caused the proliferation of profes-
sionalized advocacy and nonprofit organizations. These organizations
focus on the narrow instrumental interests of the particular constituency
they represent. There is greater reliance on litigation, advocacy for per-
sonal rather than social rights, and lobbying for legislation or regulation
targeted to benefit a particular group, which tends to be economically
privileged. Skocpol (2003, 224) writes: “Because today’s advocacy groups
are staff-heavy and focused on lobbying, research, and media projects,
they are managed from the top, even when they claim to speak for
ordinary people.” Consequently, they are more likely to represent elite
groups rather than cross-class members. These advocacy groups are
structurally centralized and staff-driven; Skocpol observes that they do
not encourage active participation by their dues-paying members and
are no longer organized as federated associations in which local chapters
are mobilized for political action at the national level.
The current study’s focus on human services leads the authors to
offer an explanation that differs from Skocpol’s but complements it.
This explanation emphasizes neoliberalism’s chilling effects on advo-
cacy, especially the effects of devolution and privatization. First, because
devolution shifts the onus of service responsibility from the national to
310 Social Service Review

the local level, social problems and needed services become framed as
local issues requiring local solutions. Thus, the national visibility of such
problems is diminished. This makes it difficult for civic associations to
coalesce around a common, national-level frame and strategy. In the
case of welfare reform, for example, national-level mobilization on be-
half of the poor is exceedingly difficult because the 1996 welfare law
grants broad discretion to the states; because of this discretion, there
is great variation in the policies and programs offered across states and
localities.
Second, privatization reduces opportunities for mobilization by dis-
banding political interests. It does so by shifting the state’s responsibility
for the quality of services, and for the policy itself, to the private sector.
Privatization places this responsibility on the shoulders of consumers,
who are expected to make choices consistent with their preferences.
Policy ends are defined by the aggregation of self-interested choices.
Voucher holders, for example, are unable to share collective experiences
that could plant the seeds of collective action (Crenson and Ginsberg
2002).
Third, as Matthew Crenson and Benjamin Ginsberg (2002) argue,
decentralized and privatized policies enable nonprofit organizations to
achieve their goals by securing contracts with government rather than
by mobilizing grassroots support. Extensive pursuit of governmental
contracts for services modifies the types of advocacy nonprofit organi-
zations engage in. In particular, pursuit of governmental contracts in-
creases the likelihood that nonprofits engage public officials in order
to obtain additional resources for their clients, and it diminishes the
likelihood that they will pursue social needs or initiate services they
perceive to have a low probability of receiving funding (Frumkin and
Andre-Clark 2000; Eikenberry and Kluver 2004). Organizations bound
to government by contracts seldom engage in challenging tactics (Mos-
ley 2006). In their national study of advocacy by nonprofit organizations,
Bass and associates (2007, 31) find that “three out of four respondents
said that receipt of government funds serves as some barrier to engaging
in policy matters.” As one executive put it, “It’s very hard to be an
advocate when you’re dependent upon state money” (33). Such an
accommodating form of advocacy promotes the view that nonprofit
organizations are interest groups that lobby on behalf of their own self-
interest rather than on behalf of the public interest. It is quite telling
that the settlement houses abandoned much of their social action mis-
sion when they became multiservice agencies under contract with gov-
ernment. Their primary political agenda now is to protect their pro-
grams, often by mobilizing their clients to connect with local politicians
in order to secure their resources (Fabricant and Fisher 2002, 207–14;
Marwell 2004).
Fourth, as nonprofit organizations become the major service provid-
 Advocacy for Rights 311

ers, they also undermine the legitimacy and responsibility of the state
to provide public services (Clemens 2006, 208). That is, devolution and
privatization reinforce an antistate ideology by advancing a perversity
thesis that government is the problem rather than the solution (Hirsch-
man 1991). By becoming major service providers, nonprofit organiza-
tions alter the relationship between civil society and government, pos-
sibly co-opting civil society to serve the political and ideological needs
of the political elites.
The nonprofit sector faces a chilling political atmosphere brought on
by the advent of neoliberalism. As Clemens suggests (2006, 214),
“Through their tax-exempt status and receipt of public funds, both
advocacy and service organizations remain vulnerable to political efforts
to use the leverage of these economic advantages to channel or choke
off political activity.” In an attempt to muzzle advocacy by nonprofit
organizations, the Reagan administration’s Office of Management and
Budget issued Circular A-122 (48 C.F.R. 31.701 [1984]). The aim, as the
conservatives stated, was to “defund the left” (Berry 1993, 34). It pro-
posed that “no federal funds could pay the allowable costs of any staff,
equipment, or facility involved in the slightest amount of political ad-
vocacy, even if the advocacy costs were paid with non-federal funds”
(Bass et al. 2007, 84). Although not enacted, the “Circular A-122 pro-
posal continues to be the backbone of conservative plans to silence the
advocacy voice of nonprofits—and it has contributed enormously to the
chill in nonprofit advocacy today” (Bass et al. 2007, 88). Subsequent
legislative attempts, including the Istook amendment (Title V, H.R.
2127, 104th Cong. [1995]), would have broadened considerably the
prohibition against advocacy by nonprofits receiving federal funds.
Clearly these unsuccessful attempts created a climate of fear and a de-
terrence among nonprofits that might otherwise be inclined to engage
in advocacy.
As noted above, when advocacy does occur, it is constrained by de-
volution and privatization to concentrate on local issues. In her study
of three national Progressive movement networks, the Association of
Community Organizations for Reform Now (ACORN), the Pacific In-
stitute for Community Organization (PICO) Network, and the Gamaliel
Foundation, Heidi Swarts (2008) shows that many of their advocacy
efforts and successes occur at the local and state levels. For example,
ACORN helped push living-wage ordinances in 16 cities, advocated to
raise the minimum wage in New York, joined coalitions in several cities
to advance charter schools, participated in a coalition to prevent na-
tional legislation that would preempt state and local laws against pred-
atory lending, and mobilized for voter registration. The PICO network
helped to place a cigarette tax initiative on the ballot in California. The
initiative would use those tax revenues to fund children’s health insur-
ance. The network also worked in several cities across the country to
312 Social Service Review

obtain additional funding for education and affordable housing. Al-

though these and other policy initiatives are noteworthy accomplish-
ments, the benefits they provide are available only to poor residents in
select localities.
Such networks are less successful in efforts to advance legislation that
promotes social rights at the national level. Swarts (2008, 183) recognizes
the dilemma facing networks such as PICO: “What began as a pragmatic
strategy to mobilize the hopeless and quiescent—choosing issues that
are ‘immediate, specific, and winnable’—discouraged organizers from
thinking beyond the local level.” Unevenly scattered victories at the local
level break up collectivities at the national level because some constit-
uents enjoy the benefits of local advocacy efforts. These local successes
reduce their motivation to join forces in advocating for social rights at
the national level.
Indeed, policy advocacy in a devolved and privatized welfare regime
is likely to be displaced by what Nicole Marwell (2004, 286) terms a
“new version of machine politics.” In her field study of community-based
organizations, Marwell finds that some of these organizations obtain
and secure government contracts by engaging in mobilization tactics to
ensure that their local constituencies vote for local politicians who will,
in turn, favor the groups in awarding contracts and grants. If successful,
these tactics can increase the number and size of government contracts
to the organizations and their local community. Yet, as Marwell (2004,
285) notes, these local “electoral efforts are limited to influencing con-
tract allocation decisions; the organization has minimal interest in cre-
ating policy change.” Indeed, the new machine politics creates a zero-
sum game: local communities that are richer in political capital gain a
greater share of the limited resources for human services, and alloca-
tions to these communities come at the expense of those communities
that are poorer in political capital. These politically driven allocations
undermine the very essence of social right. Similarly, Eve Garrow (2011)
finds that organizations engaged in advocacy are more likely to obtain
government funding than are those that do not engage in advocacy,
and those located in high-poverty areas are not likely to obtain more
government funding than organizations located in low-poverty areas.
This finding suggests that allocation of government resources is influ-
enced by the amount of political capital organizations have rather than
by a norm of social rights.
There is evidence that the current decline in national-level policy
advocacy by nonprofit organizations and civic associations has a pro-
found effect on the extent to which social rights are extended and
institutionalized. Brayden King, Keith Bentele, and Sarah Soule (2007,
149) find that the extent of congressional attention to rights issues is
related to the amount of advocacy done on behalf of those issues; Con-
gress is more likely to hold hearings on rights issues around which there
 Advocacy for Rights 313

are more than an average number of protests in the same year. The
researchers also find that the perceived legitimacy of a rights issue grows
in Congress over time with the cumulative number of congressional
hearings held on that issue. Therefore, new rights issues are more likely
to gain receptive congressional actors in subsequent sessions than in
the session during which they are first raised (King et al. 2007, 152).
Yet, the number of congressional hearings on social welfare issues (e.g.,
food assistance; poverty; assistance to low-income families, the elderly,
and the disabled; social services) suggests that there has been a precip-
itous decline in congressional attention to social welfare policy since
the 1980s (Baumgartner and Leach 2001). Figure 1 shows that the num-
ber of hearings on social welfare generally rose from 1960 to 1977. That
was also a period of active advocacy for social rights. Since then, however,
the number of hearings declined almost steadily.
Figure 1 also suggests that the current decline in advocacy limits the
effectiveness of nonprofit and civic associations in bringing media at-
tention to the issue of social rights. The figure shows the number of
articles on social welfare in the New York Times from 1960 to 2007, and
parts of the trend in published articles parallel parts of the trend in
congressional hearings on social welfare issues. The number of articles
on social welfare increased steadily from 1964 to 1975 but declined by
nearly half from 1975 to 2005 (the welfare reform debates in 1995
provide a brief exception in the trends). In their seminal paper, William
Gamson and Gadi Wolfsfeld (1993) propose that the media is critical
for effective advocacy because it helps in mobilizing supporters, vali-
dating the importance of an issue, and enlarging an issue’s scope. Re-
viewing research on social movements and media attention, Kenneth
Andrews and Neal Caren (2010, 845) conclude that “organizational
resources increase media attention because resources signal newswor-
thiness and provide greater capacity to pursue coverage.” In studying
coverage of social movements by the New York Times, Edwin Amenta and
associates (2009) conclude that media coverage increases when move-
ments engage in disruptive activities, mobilize resources (i.e., other sup-
portive organizations), and advocate in a favorable political regime for
an enforced policy that favors their constituencies. The authors of the
current study infer therefore that the obverse is also true: when there
is a decline in media coverage, advocacy groups do not engage in protest
activities, fail to mobilize sufficient resources, advocate to an unfavorable
political regime, and face policies that disfavor their constituencies.
These factors would indeed explain why advocacy groups have failed to
draw media attention to social welfare since the 1980s.
Finally, the dampening of advocacy activity by nonprofit organizations
and civic associations, and the resulting decline in congressional atten-
tion to social rights, may have created a feedback loop that further
diminishes advocacy. In general, congressional attention to issues that
 Fig. 1.—Congressional Hearings and New York Times Index on Social Welfare, 1960–2007. Source: Center for American Politics and Public Policy’s
Policy Agendas Project (http://www.policyagendas.org/). The data used here were originally collected by Frank R. Baumgartner and Bryan D. Jones,
with the support of National Science Foundation (grants SBR 9320922 and 0111611), and were distributed through the Department of Government
at the University of Texas at Austin. Neither the National Science Foundation nor the original collectors of the data bear any responsibility for the
analysis reported here. Results from the New York Times Index represent a systematic random sample of articles published in the Times between 1960
and 2005. Results for congressional hearings represent the number of hearings held on social welfare issues during that period.
 Advocacy for Rights 315

nonprofits care about is the engine that drives advocacy and lobbying
at the national level (Leech et al. 2005; Baumgartner et al. 2009). That
is, “As government attention to an issue-area increases, so too will lob-
bying in that issue-area” (Leech et al. 2005, 21). Conversely, when leg-
islative attention to social welfare issues declines, advocacy on behalf of
these issues is also expected to decline. If that is so, the current decline
in advocacy can be attributed in part to the failure of advocacy groups
to make social rights a national issue, through the media or otherwise,
as this failure decreases congressional attention to social rights. In turn,
lack of congressional attention makes it difficult to bring up new social
rights issues.

Is Policy Advocacy for Social Rights Possible in

a Neoliberal Regime?
This article argues that the rise of a neoliberal ideology, as manifested
by devolution and privatization, curtailed the nonprofit sector’s histor-
ical mission to advocate for and mobilize on behalf of social rights. The
authors also theorize about the political opportunities that may enable
policy advocacy even in the context of a neoliberal regime. The dis-
cussion distinguishes between institutionalized and emerging policy
fields to show that the latter can create a political opportunity for ad-
vocacy to advance social rights (Kriesi 2008).
In an institutionalized policy field, and in the correspondent orga-
nizational field (such as welfare), the political struggles between neo-
liberal and social rights logics are settled. The dominant neoliberal
policy logic and narrative come to define the moral categorization of
the target population, its problems, the desired outcomes, and the
modes of intervention (Schneider and Ingram 1993; Steensland 2010).
The corresponding organizational field embodies the logic in its insti-
tutional rules and practices. The opportunities for advocacy become
constrained not only by the policy itself but also by the bureaucracy that
implements it and by the isomorphic pressures of the human-services
organizational field that depends on it.
In contrast, when a new social problem is discovered in an emerging
field (e.g., homelessness or HIV/AIDS during the 1980s), power posi-
tions are not consolidated; the social policies and public bureaucracies
that define the nature of the problem and the array of possible solutions
may not exist. The human-service organizations that arise in response
to the problem have a political opportunity to frame it in moral terms
that can advance social rights. The organizations are not constrained
by dependence on existing policy, government funding, or legitimacy,
and they are not bound by the isomorphic pressures of an established
organizational field (Cress and Snow 2000).
316 Social Service Review

Such an opportunity is exemplified in struggles during the 1980s to

achieve social rights for homeless persons. The struggle culminated in
the passage of the McKinney Act (101 Stat. 482 [1987]) when the neo-
liberal regime became dominant. As Daniel Cress and David Snow (2000,
1073) point out, “The vast majority of homeless collective actions—such
as protest rallies and marches, housing takeovers, and encampments on
government property—were local in organization and focus.” Still, local
advocates were also able to mobilize and coalesce nationally. Perusal of
congressional hearings leading to the McKinney Act shows that a ma-
jority of the witnesses who advocated for the right to shelter represented
organizations that provided human services for homeless. Examples of
these organizations include shelter operators, coalitions for the mentally
ill, the Women’s Housing Coalition, Catholic Charities, the Council of
Jewish Federations, and the Salvation Army. Gary Blasi (2000, 218) ar-
gues that the “new” homelessness enabled the National Coalition for
the Homeless and other advocacy groups around the country to frame
the cause of homelessness as a structural (e.g., lack of housing) rather
than an individual deficiency. This allowed advocates to mobilize the
media to echo such an explanation. The advocates also received help
from public opinion surveys, which showed that homelessness was unlike
welfare or poverty, in that a public majority blamed society for home-
lessness (Blasi 2000, 215–17). Moreover, Blasi (2000, 227–37) notes that
public perceptions of the “homeless” were not racialized. Reluctantly
signed by President Reagan, the McKinney Act failed to advance the
right to shelter, but it did recognize homelessness as a national problem
requiring federal response (Foscarinis 1996).
The passage of the Ryan White Comprehensive AIDS Resources Emer-
gency Act of 1990 (104 Stat. 576) represents another example of mo-
bilization to extend social rights in a neoliberal regime. In this case,
advocates acted on behalf of persons with HIV/AIDS. With the AIDS
epidemic, a policy field emerged in which advocates, politicians, the
media, local and national government agencies, private and public med-
ical research organizations, and newly formed AIDS service organiza-
tions engaged in a political struggle to define the nature and effect of
the epidemic as well as the policy responses to it (Epstein 1996; Levitt
and Rosenthal 1999).
Early in the epidemic, gay and lesbian activists formed a network of
local AIDS service organizations. This network developed in response
to state and municipal reluctance to provide needed services and in
response to the hostility with which governments met requests for those
services (Levitt and Rosenthal 1999, 785). Accompanying the network’s
rise were the emergence and mobilization of the “AIDS movement,”
which Steven Epstein (1996, 8) describes as “broad based and diverse,
ranging from grassroots activists and advocacy organizations to health
educators, journalists, writers, and service providers; it cuts across the
 Advocacy for Rights 317

various communities and constituencies affected by the AIDS epidemic.”

The movement’s membership enhanced its powerful political mobili-
zation and fundraising capabilities; many of its members were middle-
and upper-income whites with considerable “cultural capital” (Epstein
1996, 12).
Moreover, the framing of the target population shifted by the mid-
1980s; the stereotype that AIDS affects gay men and injection drug users
broadened to include hemophiliacs perceived as “innocent victims”
(Donovan 1993, 11). This shift is epitomized by the story of Ryan White,
a hemophiliac boy who became infected with HIV and was shunned
from school. As Mark Donovan notes (1993, 13), “This shift in public
consciousness provided an opportunity for policymakers to construct
AIDS policy which could deliver benefits to ‘deserving’ target popula-
tions.” It gave politicians the legitimacy and political cover to pass the
1990 act, which provides emergency relief grants to states and cities.
The grants fund health and support services to HIV-positive individuals
as well as early intervention services for persons who contract or are at
risk to contract HIV.
The administration of both the McKinney and Ryan White acts is still
markedly constrained by the neoliberal emphasis on devolution. Local
authorities have considerable discretion in how to use and allocate the
grants. As a result, the benefits provided through the acts cannot be
viewed as entitlements because they are subject to the political vagaries
of the federal budget. Rather, the acts set up a complex system of fund-
ing criteria; under that system, different programs serve various target
groups and are administered by a broad array of providers that range
from state governments to nonprofit organizations (Siplon 1999, 799).
Although the acts recognize and support funding to meet some of the
needs of vulnerable populations (in this case, the homeless and persons
with HIV/AIDS), their administration sets considerable barriers to the
exercise of social rights.

Conclusion
Human-service associations have played an important role in advocating
for the expansion of the welfare state and in the institutionalization of
social rights. However, this historical role is challenged under neolib-
eralism and the resulting new economics and politics of social care.
Devolution and privatization, including contracting out, are powerful
forces that erode social citizenship and threaten the autonomy of civil
society as a mobilizing force that advocates on behalf of the poor and
the marginalized. Under the new economics and politics of care, human-
service organizations conceptualize their clients as customers rather
than as citizens. As a result, the organizations obscure the importance
of the state in protecting their social rights. Neoliberalism evokes the
318 Social Service Review

image of local empowerment in rationalizing devolution and privati-

zation. In reality, neoliberalism disempowers the poor and the vulner-
able by turning them into consumers rather than citizens, a shift that
can deprive them of their already precarious social rights.
Operating within a political economy of contracts, privatization, and
marketization chills nonprofit human-service organizations’ interest in
and ability to engage in policy advocacy. It also limits their ability to
mobilize for expansion of social rights. Advocacy, when it does occur,
typically centers on obtaining benefits and resources for local constit-
uencies. Only when new social problems arise and are coupled with an
emerging policy field is there an opportunity to advocate on the national
level.
In the final analysis, the ability of civil society to advocate on behalf
of poor and vulnerable populations hinges on two factors: the extent
to which the public sphere is independent of government and the extent
to which civil society is protected from market forces. These conditions
do not prevail in a neoliberal welfare regime.

Note
Yeheskel Hasenfeld is distinguished professor of social welfare at the Univer-
sity of California, Los Angeles, Luskin School of Public Affairs. He has published
extensively on the attributes of human-service organizations and, with Joel Han-
dler, on poverty and welfare reform. Currently, he is studying the role of non-
profit organizations, including social enterprises, in the provision of social ser-
vices. His most recent edited volume, with Benjamin Gidron, is Social Enterprises:
An Organizational Perspective (New York: Palgrave, 2012). Eve E. Garrow is an
assistant professor at the University of Michigan School of Social Work. Her
research seeks to understand how human-service organizations respond to, man-
age, and influence social policy and diverse and contradictory demands from
their environments. She examines the consequences for policy implementation,
human-service delivery, and client outcomes. The authors thank Mayer Zald for
his encouragement and thoughtful suggestions, and the anonymous reviewers
for their insightful comments on earlier drafts.

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